In Sri Lanka, FHIR has become the main standard for exchanging healthcare data. FHIR (Fast Healthcare Interoperability Resources) is a global standard that helps different health systems share information.

The country uses FHIR version R4 across its implementations. Other versions are not in active use.

Adoption is expected to grow strongly in the coming years, driven by national digital health programs.

Rules and Support

Sri Lanka has clear national rules for health data exchange:

  • Regulation requires the use of standards for electronic health data exchange.
  • FHIR is specifically mandated in the regulation.
  • No compliance deadline has been set.
  • No fines are imposed for non-compliance.
  • No government funding is currently available to support FHIR adoption.

You can read the official documents here:

National Setup

Sri Lanka has a structured approach to health data standards:

  • The Ministry of Health leads standards work through its e-Health Steering Committee.
  • A dedicated Interoperability Working Group creates and publishes the standards.
  • A national base FHIR implementation guide is published and used in a limited set of use cases. You can view it here: Sri Lanka FHIR Implementation Guide.
  • A national FHIR terminology server is currently in development.
  • There is no known activity yet around the FHIR Community Process (FCP), and none is expected in the next 2–3 years.

Active Use Cases

A few specific FHIR standards are being developed in the country. The main focus area is:

  • Encounter Summary for the National Electronic Health Record

Who's Using FHIR

The main groups adopting FHIR in Sri Lanka are:

  • Care providers
  • EHR system vendors (Electronic Health Record systems)
  • Clinical registries
  • Government agencies

The main drivers behind adoption are:

  • Regulation and grants
  • Patient access to their health data

In terms of how FHIR is used, the REST API approach is the dominant exchange mechanism. FHIR Shorthand (a simple way to write FHIR specifications) is also widely applied. SMART on FHIR is used in a limited way, while messaging, documents, and other tools are not yet in active use. The country leans strongly toward open source software for FHIR.

Success Stories and Challenges

A successful pilot has already shown the value of FHIR in Sri Lanka:

  • A pilot project submitting demographic and encounter summary data to the National Electronic Health Record.
  • The main benefit so far has been improved access to information.

The biggest challenges include:

  • High investment costs
  • Unclear benefits for some stakeholders
  • A general lack of FHIR knowledge

Looking ahead, the country is preparing for the full implementation of the National Electronic Health Record.

Future Plans

Progress over the past year has matched expectations. Key achievements include:

  • Development of new FHIR standards for specific use cases
  • Launch of pilot projects with selected healthcare stakeholders

Overall satisfaction with the pace of adoption is neutral. In the coming year, the country expects expanded adoption of FHIR across the healthcare ecosystem.

There is solid optimism that within three years, FHIR will deliver real benefits, including cost savings, better care coordination, and a stronger digital health ecosystem.

Contributors

  • Chaminda Weerabaddana, Sri Lanka College of Health Informatics

The above summary is based on the answers to the State of FHIR Survey 2026, organized by Firely and HL7 International.